Ella Stiebel, a student social worker from Melbourne, fell ill days after a family hike through the Balinese jungle. She became too sick to eat, too weak to walk, and so sensitive to light that even looking at a phone screen made her wince. A blood test after 2½ weeks confirmed dengue. The night before flying home, Stiebel had a panic attack, fearing the altitude on the plane would make her brain explode.
Dengue is a viral fever spread by mosquitoes. While most patients recover after a week, some develop a severe hemorrhagic form requiring hospitalisation, causing internal bleeding and potentially death. Catching the disease a second time can disrupt the immune system catastrophically, according to Dr Deb Mills, medical director of the Travel Medicine Alliance. "People get bleeding into their skin, and basically, their blood pressure drops, and they can die. So it can be really, really bad," she said.
An estimated three in four cases are asymptomatic. ATAGI notes that half of Australia's top 10 most-visited places — Indonesia, Thailand, India, Vietnam and Fiji — have frequent or persistent dengue transmission. There are four types of the virus; the Qdenga vaccine provides protection against all four.
The vaccine has been available for a couple of years but required extensive paperwork and cost $500 per dose, with two doses needed. "It was a hefty expense," Mills said. More supply of the live-attenuated virus is now expected, improving access.